Eating Disorder Attitudes and Behaviors Among Non-Binary Individuals

Can you think of the moment in your life when you recognized your individual identity? What if, when you finally figured out who you are, your body told a different story. Those who identify as non-binary may feel just that their body does not reflect who they are.

A desire for the body to reflect an individual or identity can lead to a yearning to alter the body. Gender-expansive and transgender people’s attitudes and behaviors related to eating, shape, and weight may be skewed due to this desire. Attitudes and behaviors may also reflect a longing to avoid discrimination and to be accepted.

Identities Beyond the Binary

Gender-expansive describes a variety of gender identities that do not fit within the constraints of cisgender or binary gender identities (man or woman). This can include individuals who do not identify with a specific gender; those who identify with a combination of woman and man, and individuals whose gender identity may change over time [2].

Some identities within gender-expansive include genderqueer (a term often used synonymously with gender non-binary), pangender (identifying with multiple or all genders), and gender-fluid (a gender identity that changes over time) [2].

Transgender describes individuals whose sex at birth does not match their current gender identity [3]. Transgender can describe an array of identities, including female-to-male (FTM) or transgender male, male-to-female (MTF) or transgender female, as well as non-binary identities including gender-nonconforming and genderqueer [1].

It is important to name that not all transgender individuals identify as gender-expansive or non-binary. Also, to name that, not all individuals who identify as gender-expansive or non-binary also identify as transgender [2].

Attitudes and Behaviors Related to Body Shape and Weight Concerns 

The formation of eating disorders and body image issues in gender-expansive and transgender individuals is likely related to discrimination, stigma, and prejudice [2]. It is important to note that each gender minority may have different stressors elevating their risk of disordered attitudes and behaviors [2].

Gender-expansive Individuals may fear their gender identity will not be accepted due to psychological stressors, including identity invalidation, decreased social support, and increased discrimination [2].

Individuals may experience dissatisfaction or body dysphoria when their gender identity and their sex at birth or the shape of their body do not match [2]. Moreover, invalidation or refusal of society to accept non-binary identities as “real” or “true” may further increase psychological distress for gender-expansive individuals [2].

Transgender men and women may have different stressors, including society’s body ideals specific to their gender identity (man or woman) [2]. Transgender men and women may fear not “passing” as a woman or man based on the unrealistic media-based standards [3].

The media’s unachievable beauty standards have decreased the satisfaction and appreciation individuals have for their bodies. These standards impact self-esteem, increasing concerns around the shape and weight of the body and desire to alter the body using disordered eating behaviors and exercise [3].

Each individual’s perceived ideals related to shape and weight will drive behaviors they use to achieve perceived ideals [2]. Eating disorders may result from these dissatisfactions with the belief that behaviors may help attain their ideal or accepted shape or bodyweight [2].

Attitudes and Behaviors Related to Dietary and Eating Concerns 

Those within gender minorities face unique psychosocial stressors. These stressors may contribute to maladaptive eating attitudes and behaviors [2]. Again, it is important to understand that gender minority groups experience distinct stressors, including identity invalidation, decreased social support, and increased discrimination [1].

A recent study revealed that out of their gender-expansive participants, nearly 25% reported recently engaging in dietary restraint, and 12.9% reported engaging in objective binge episodes [2]. Another study showed non-binary participants were significantly more likely to report an ED diagnosis compared to participants with a binary (man or woman) gender identity [1].

Transgender and gender-expansive individuals may take on disordered eating patterns, including restriction, binging, purging, laxative abuse, and over-exercise behaviors, to create a perceived “acceptable” appearance [2]. For transgender men and women, appearing cisgender (man or woman) may be seen as a form of protection again discrimination and violence [1].

Unfortunately, some individuals may see eating disorders or disordered eating as their only way to achieve acceptance or control by changing their body weight or shape. Understanding the manifestation of attitudes and behaviors in gender-expansive and transgender populations is crucial to being able to assess, support, and treat shape, weight, and eating concerns [2].

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Resources:

[1] Diemer, E. W., White Hughto, J. M., Gordon, A. R., Guss, C., Austin, S. B., & Reisner, S. L. (2018). Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample. Transgender Health, 3(1), 17–23. https://doi.org/10.1089/trgh.2017.0043

[2] Nagata, J. M., Compte, E. J., Cattle, C. J., Flentje, A., Capriotti, M. R., Lubensky, M. E., Murray, S. B., Obedin-Maliver, J., & Lunn, M. R. (2020). Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among gender-expansive populations. Journal of Eating Disorders, 8(1). https://doi.org/10.1186/s40337-020-00352-x

[3] Tabaac, A., Perrin, P. B., & Benotsch, E. G. (2017). Discrimination, mental health, and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model. Journal of Gay & Lesbian Social Services, 30(1), 1–16. https://doi.org/10.1080/10538720.2017.1408514

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published May 27, 2021 on EatingDisorderHope.com
Reviewed & Approved on May 27, 2021, by Jacquelyn Ekern MS, LPC